Fast beneficial systemic anti‐inflammatory effects of inhaled budesonide and formoterol on circulating lymphocytes in asthma

Rüdiger, Jochen J.; Gencay, Mikael; Yang, Jin; Bihl, Michel; Tamm, Michael; Roth, Michael

doi:10.1111/resp.12104

Cited by 18 publications

(13 citation statements)

References 43 publications

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“…However, there was an insufficient number of related. Only one study assessed the effect of ICS on the hypothamo-pituitary-adrenocortical axis, in which Rüdiger et al (18) found that single low dose ICS did not influence this endocrine axis. Bousquet et al (12) also claimed that 3 weeks of high dose ICS did not increase the number of patients experiencing adverse events (RR, 1.00; 95% CI, 0.42 to 2.4).…”

Section: Resultsmentioning

confidence: 99%

“…Short-term ICS use is believed to be safe (12,18); however, longer treatment with high dose ICS may decrease bone mineral density and increase the risk of osteoporosis or fracture in patients with persistent asthma, but the effect of low dose ICS on bone mineral density and risk of osteoporosis or fracture was slight (28). Dysphonia or oral candidiasis may also develop, but it could almost be prevented by rinsing the mouth after ICS use (33).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inhaled corticosteroids improve lung function, airway hyper-responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta-analysis

Zhou

et al. 2017

Experimental and Therapeutic Medicine

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It remains controversial whether inhaled corticosteroid (ICS) should be used in patients with intermittent asthma. The present study aimed to assess the effect of ICS compared with placebo or other therapies in patients with intermittent asthma. Medline, Embase and CNKI databases were searched up to June 2016 and a meta-analysis was conducted. The findings demonstrated that in adult patients, when compared with placebo, ICS increased forced expiratory volume in 1 sec FEV1 [standardized mean difference (SMD), 0.51; 95% confidence interval (CI), 0.22–0.80] and alleviated airway hyper-responsiveness, which was indicated as log transformed PC20FEV1 (concentrations of methacholine when there was a fall in FEV1 ≥20%; SMD, 0.87; 95% CI, 0.60 to 1.14). ICS also reduced fractional exhaled nitric oxide (FeNO) levels [weighted mean difference (WMD), −12.57 parts per billion (ppb; a unit of NO concentration in exhaled air); 95% CI −15.88 to −9.25 ppb]. However, symptom scores did not change after ICS treatment (SMD, −0.26; 95% CI, −0.52 to 0). When compared with leukotriene receptor antagonists (LTRA), ICS had no advantage in increasing FEV1 (WMD, 0.04 l; 95% CI, −0.06 to 0.13 l), reducing sputum eosinophil percentage (WMD, −6%; 95% CI, −12.38 to 0.38%) or symptom scores (SMD, 0.44; 95% CI, −0.02 to 0.9). However, in child patients, ICS significantly (P<0.05) increased the possibility of symptom control when compared with placebo [relative risk (RR), 8; 95% CI, 1.04 to 61.52] or LTRA (RR, 2.67; 95% CI, 0.39 to 18.42). In conclusion, ICS improves lung function and alleviates airway hyper-responsiveness and airway inflammation but cannot influence symptom scores, and has no advantage over LTRA in terms of lung function improvement and airway inflammation control in adult patients with mild intermittent asthma. However, in children, the benefit of ICS in symptom control is more significant than with LTRA.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inhaled corticosteroids improve lung function, airway hyper-responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta-analysis

Zhou

et al. 2017

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

show abstract

“…Eickelberg et al [22] showed that LABAs could in vitro activate the receptor for ICS and potentiate its effects. Rüdiger et al [23] revealed that inhalation of budesonide activated the glucocorticoid receptor in peripheral blood leukocytes within 30 minutes, and the signal declined thereafter. Formoterol inhalation also activated the glucocorticoid receptor, but not before 60 min, Descalzi et al performed their study on human bronchial broblasts.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of beclometasone dipropionate and formoterol in an extrafine particle formulation for asthma therapy depending on patient smoking status: the CASPER noninterventional, observational trial

Kupryś‐Lipińska¹,

Dębowski²,

Pałczyński³

et al. 2020

Preprint

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Background: The goal of asthma treatment, outlined by GINA experts, is to achieve and maintain full control of the disease. One critical risk factor for poor asthma control is exposure to tobacco smoke.The purpose of this analysis isto assess the effectiveness and safety of long-term therapy with an extrafine combined aerosol formulation of beclometasone dipropionate and formoterol (BDP/F) in asthmatics for current and ex-smokers vs non-smokers.Methods: The CASPER study was an observational, noninterventional, prospective, multicentre trial.Asthmatics currently being managed long-term with BDP/F pressurized metred-dose inhaler (pMDI) were divided based on smoking status into three groups: current smokers, ex-smokers, and nonsmokers. The subjects were evaluated at 0, 3, and 6 months for symptom intensity, asthma control, frequency of exacerbations and dose of inhaled corticosteroids. Adverse drug reactions were also monitored.Results: Out of 16,844 patients, 2833 (16.8%) were ex-smokers and 3312 (19.7%) were current smokers. At the beginning of the observation, the current smokers were the most symptomatic subgroup of patients with the greatest limitation on life activity. During long-term treatment with extrafine BDP/F-pMDI , diurnal and nocturnal asthma symptoms, rescue medication use, and limitations of activity secondary to asthma were markedly decreased in all subgroups, with a statistically significant effect in smokers and ex-smokers, albeit at the end of the observation, a higher percentage of symptomatic patients remained in the groups of current smokers and exsmokers while a lower percentage of symptomatic patients was observed among the non smokers. At the 6-month follow-up, an improvement in asthma control compared to baseline, according to GINA criteria, was reported in 77.1% of current smokers, 75.2% of exsmokers, and 75% of non-smokers, but full asthma control was more frequently achieved in non smokers (64.0% fulfilled GINA criteria of asthma control) compared to current smokers and ex-smokers (54.9% and 51.5%, respectively). A total of 525 nonserious ADRs were reported in 422 patients (3.2%), all of which were within expectations.Conclusions: Combination therapy with extrafine BDP/F-pMDI is an effective therapy across a broad

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“…In addition to the direct airway effects of combination inhalers, systemic anti‐inflammatory effects have also been studied. Circulating lymphocytes from subjects with mild asthma or healthy controls were stimulated with lipopolysaccharide or phytohaemagglutinin . The combination of formoterol and budesonide synergistically activated the glucocorticoid receptor in peripheral lymphocytes within 30 min.…”

Section: Airway Biologymentioning

confidence: 99%

Year in review 2013: Chronic obstructive pulmonary disease, asthma and airway biology

Lim

Hancox

et al. 2014

Respirology

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Fast beneficial systemic anti‐inflammatory effects of inhaled budesonide and formoterol on circulating lymphocytes in asthma

Abstract: Combined budesonide and formoterol may reduce airway inflammation and immune reactivity of circulating lymphocytes through its local and systemic effects.

Cited by 18 publications

References 43 publications

Inhaled corticosteroids improve lung function, airway hyper-responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta-analysis

Inhaled corticosteroids improve lung function, airway hyper-responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta-analysis

Effectiveness of beclometasone dipropionate and formoterol in an extrafine particle formulation for asthma therapy depending on patient smoking status: the CASPER noninterventional, observational trial

Year in review 2013: Chronic obstructive pulmonary disease, asthma and airway biology

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